Provider Demographics
NPI:1265000251
Name:HEYN, DANIEL ALAN (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALAN
Last Name:HEYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 RENNER DR
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540-7103
Mailing Address - Country:US
Mailing Address - Phone:707-725-3318
Mailing Address - Fax:
Practice Address - Street 1:3302 RENNER DR
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-7103
Practice Address - Country:US
Practice Address - Phone:707-725-3318
Practice Address - Fax:707-725-1998
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA197739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine